An echocardiogram is a test that uses sound waves to create a moving picture of your heart. The picture is much more detailed than a plain X-ray image and involves no radiation exposure. An echocardiogram allows doctors to see the heart beating, as well as heart valves and other structures of the heart.

How the Test is Performed

TRANSTHORACIC ECHOCARDIOGRAM (TTE) is the type of echocardiogram most people have.

• A trained sonographer performs the test, and then a cardiologist interprets the results.
• An instrument called a transducer that releases high-frequency sound waves is placed on your ribs near your breast bone and is directed toward your heart. Other images will be taken underneath and slightly to the left of your nipple and in the upper abdomen area.
• The transducer picks up the echoes of sound waves and transmits them as electrical impulses. The echocardiography machine converts these impulses into moving pictures of your heart.
• Pictures can be two-dimensional or three-dimensional, depending on the part of the heart being evaluated and the type of machine.
• A Doppler echocardiogram uses a probe to record the motion of blood through the heart.

How to Prepare for the Test

There is no special preparation for the test.

How the Test Will Feel

You will be asked to remove your clothes from the waist up and lie on an examination table on your back. Electrodes will be placed on your chest to allow for an ECG to be done. A gel will be spread on your chest and then the transducer will be applied. You will feel a slight pressure on your chest from the transducer. You may be asked to breathe in a certain way or roll over onto your left side.

Why the Test is Performed

This test is completed to evaluate the valves and chambers of your heart in a noninvasive way. The echocardiogram allows doctors to diagnose, evaluate, and monitor:

• Abnormal heart valves
• Atrial fibrillation
• Congenital heart disease
• Damage to the heart muscle in patients who have had heart attacks
• Heart murmurs
• Infection in the sac around the heart (pericarditis)
• Infection on or around the heart valves (infectious endocarditis)
• Pulmonary hypertension
• The pumping function of the heart for people with heart failure
• The source of a blood clot after a stroke or TIA

Bubble Study with an Echocardiogram

Saline contrast study (bubble study). With this approach, a sterile salt solution is shaken until tiny bubbles form and then is injected into a vein. The bubbles travel to the right side of your heart and appear on the echocardiogram. If there’s no hole between the left atrium and right atrium, the bubbles will simply be filtered out in the lungs. If you have a patent foramen ovale, some bubbles will appear on the left side of the heart. This is typically completed at the end of the echocardiogram study, but can be completed independently.